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PCM Spring 2015 Exam 1 > Female GU and Breast Exam - King > Flashcards

Female GU and Breast Exam - King Flashcards

1
Q

female GU and breast exam

A

talk before touch
touch neutral area first

have patient empty bladder**

be gentle and prepared

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2
Q

female hair distribution

A

tanner stages

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3
Q

inspection of female external genital

A 
large clitoris - endocrine
labia major and major
urethral orifice
vaginal introitus
bartholin gland
skene gland
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4
Q

labia trauma

A

sexual abuse

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5
Q

hypertrophic clitoris

A

looks like penis

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6
Q

herpes

A

painful vesicles to ulcerations

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7
Q

HPV

A

cauliflower warts

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8
Q

primary syphilis

A

painless chancre

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9
Q

condyloma lata

A

syphilis

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10
Q

vulvar carcinoma

A

epidermoid squamous cell

slow growing

rare

ulcerated flat lesion

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11
Q

lichen planus

A

white plaques and ulcerations

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12
Q

cottage cheese

A

candida infection

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13
Q

ulcerations and inflammation of labia

A

trichomonas infection

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14
Q

bartholin glands

A

4 and 8 oclock

secretory glands - can become clogged with bacteria

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15
Q

labial pain and swelling

A

inspect and palpate the bartholin glands

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16
Q

causes of bartholin gland abscess

A

gonococcus and chlamydia

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17
Q

skene gland issue

A

more rare infection

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18
Q

inadequate pelvic support

A

cystocele
rectocele
uterine prolapse

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19
Q

first degree uterine prolapse

A

cervix droops into vagina

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20
Q

second degree uterine prolapse

A

cervix comes down to opening of vagina

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21
Q

third degree uterine prolapse

A

cervix outside the vagina

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22
Q

fourth degree uterine prolapse

A

entire uterus outside vagina

procidentia

weakness all supporting muscles

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23
Q

insertion of speculum

A

pressure to posterior wall of vagina

anterior wall - sensitive

45 degrees*

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24
Q

90% cervical cancers

A

transformation zone

area of squamous metaplasia

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25
nabothian cyst
inclusion of cyst of endocervical glands normal variant - completely b9 - mistaken for carcinoma of cervix
26
pap smear
papanicolaou test for screening malignant processes of cervix cells from transformation zone
27
cervicitis
infection - chlamydia - gonnococcus - trichomonas - HSV - HPV
28
inspection of vagina
as withdraw speculum**
29
bimanual exam
uterus and ovary info also cervix and strength of pelvic floor
30
version
relationship of fundus of uterus and vagina
31
flexion
relationship between fundus of uterus and cervix
32
rectovaginal exam
examine pouch of douglas - rectovaginal pouch retroverted/retroflexed uterus rectum exam
33
most common hernia in women
indirect
34
femoral hernia
more in women than in men
35
top cancer killer in women
lung 2nd is colon
36
anatomy of breast
15 to 20 lobes each with several lobules suspensory ligaments of cooper - structural support
37
ducts of breasts
dilated portion - lactiferous sinus -lined by stratified squamous epithelium major ducts - lined by two layers of cuboidal cells -minor ducts - single layer of columnar or cuboidal cells
38
extent of breast
2-3 rib to inframammary fold at 6-7 rib lateral border of sternum to anterior axillary line**
39
greatest volume of breast
upper outer quadrant
40
posterior surface of breast
rests on fascia of pectoralis major, serratus anterior, and external abdominal obliques and upper extent of rectus sheath
41
blood supply to breast
internal mammary artery posterior intercostal arteries axillary artery arborize as medial mammary arteries
42
axillary lymph nodes
breast drainage
43
drainage across sternum
can occur with lymph from breasts
44
optimal time for breast exam
5-7 days following last menstrual period
45
erythema
mastitis | inflammatory carcinoma
46
bloody nipple discharge
cancer
47
non-bloody nipple discharge
endocrine
48
nipple ulceration
pagets disease | or mechanical causes
49
breast inspection
- seated arms at side - arms over head - hands against hips - palms together - arms extended and bent forward at waist
50
paget disease of breast
epidermal cancer of areola or breast ca grows slowly presentation - scaly ulcerating change to nipple**
51
scaly ulcerating change to nipple
paget diagnosis - biopsy
52
nipple retraction
not good cancer sucks things to center
53
mastitis
confused with inflammatory breast cancer often have coexisting lactation** infection of breast tissue
54
peau d'orange
inflammatory breast cancer
55
palpation of breast
cover ENTIRE breast**
56
breast cancer
women over 50 single irregular or stellate shape firm or hard not clearly demarcated fixed to skin or underlying tissue nontender retractions present
57
fibroadenoma
single, may be multiple round, disclike soft well demarcated very mobile nontender
58
cyst
single or multiple round soft to firm well delineated mobile often tender absent
59
breast ca risk fx
``` previous hx breast ca #1 fam hx #2 increased age nulliparous first child after age 30 early menarche estrogen and HRT radiotherapy of chest smoking ```
60
presentation of breast ca
90% lump painless 20% painful lump 10% nipple discharge
61
stage 1 breast ca
no more than 2m in diamter no nodes and no mets 98% 5 yr survival
62
stage 2 breast ca
2-5cm small with less than 4 nodes big tumor with no nodes no mets
63
stage 3 breast ca
tumor to nodes
64
stage 4 breast ca
tumor mets
65
inflammatoy breast cancer
stage 3 cancer spread to breast skin - swelling and redness 50% 5 yr survival
66
primary dysmenorrhea
results from increased prostaglandin produc- tion during the luteal phase of the menstrual cycle, when estrogen and progesterone levels decline
67
Causes of secondary dysmenorrhea
include endometriosis, adenomyosis (endometriosis in the muscular layers of the uterus), pelvic inflammatory disease, and endometrial polyps
68
pain from ovulation at midcycle
mittelschmerz
69
most common STI in women
chlamydia trachomatis
70
pediculosis pubis
lice or crabs

PCM Spring 2015 Exam 1 (6 decks)

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